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Why are Most Disability Cases Denied in California?



 
If you attempt to deal with the shortened version of this question, "Why are disability cases denied?", you'll come up with a variety of answers.

In general terms, some cases may be denied because the determination has been made that a claimant can return to their past work. In other cases, a Social Security Disability denial may be issued because while it was concluded that a claimant could not return to one of their former jobs, it was nonetheless concluded that they could, based on their age, education, work skills, and level of functional limitations, transition to some type of "other work".

In more specific terms, we can say that some cases in California are probably denied because a claimant's doctor failed to provide a residual functional capacity statement that might have sufficiently spelled out just how limiting a claimant's medical or mental condition is, and how their current and anticipated level of functioning rules out the ability to engage in work activity. And, in yet other cases, we can say that a disability denial may have occurred because the claimant's work history was not properly identified.

However, in this post, we're not dealing with the shortened version, but the longer version of the question which is "Why are most disability cases denied?". And the answer to that question is very simple, though it comes in two parts:

1. A lack of medical evidence.

2. A lack of medical evidence that sufficiently documents the existence of functional limitations that effectively rule out a person's ability to work and earn a substantial gainful income, either at a job they've done in the past, or at some other type of work for which they might be suited based on the vocational factors we mentioned in the second paragraph.

Of course, this highlights, once again, two very important things to keep in mind for individuals who are filing for disability and even individuals who are considering applying for disability.

One is to make sure that when you apply for disability (or do an appeal) you supply detailed and accurate information regarding your history of medical treatment. Because even if you have been treated, if the disability examiner working on your case cannot access those medical records, they might as well not exist.

Secondly, make sure that you seek treatment for your condition or conditions, whether they are physical, mental or both. Sometimes, this can seem pointless to individuals with chronic conditions for which there are few, if any, treatment options. And continuing to seek medical treatment for such an impairment can seem particularly pointless when a claimant's own doctor has released them under the rationale that they cannot help them any further.

However, from a disability claim processing standpoint, the only thing that really matters is that you have medical evidence to back up your claim for disability. Because without the proof that comes from medical record documentation, a claimant's rationale for applying for disability benefits is nothing more than a set of allegations. Which is why SSA uses the phrase "alleged onset date" (AOD) of disability and when a disability claim is approved the operative phrase then becomes "established onset date" (EOD) of disability.








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For the sake of clarity, SSDRC.com is not the Social Security Administration, nor is it associated or affiliated with SSA. This site is a personal, private website that is published, edited, and maintained by former caseworker and former disability claims examiner, Tim Moore, who was interviewed by the New York Times on the topic of Social Security Disability and SSI benefits in an article entitled "The Disability Mess" and also by the Los Angeles Times on the subject of political attempts to weaken the Social Security Disability system.

The goal of the site is to provide information about how Social Security Disability and SSI work, the idea being that qualified information may help claimants pursue their claims and appeals, potentially avoiding time-consuming mistakes. If you find the information on this site helpful and believe it would be helpful to others, feel free to share links to its homepage or other pages on website resource pages, blogs, or social media. Copying of this material, however, is prohibited.

To learn more about the author, please visit the SSDRC.com homepage and view the "about this site" link near the bottom of the page.